Healthcare Provider Details

I. General information

NPI: 1235851585
Provider Name (Legal Business Name): KAYLA ORCUTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 TOLL HOUSE AVE
FREDERICK MD
21701-4516
US

IV. Provider business mailing address

3512 CEMETERY CIR
KNOXVILLE MD
21758-9641
US

V. Phone/Fax

Practice location:
  • Phone: 301-696-3129
  • Fax:
Mailing address:
  • Phone: 410-935-8049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17692
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: